I am reading that 400 mg of Selinium, Brocoli, Brocoli Capsules, Soy Protein and Green Tea can slow down or even prevent prostate cancer. Does anyone have any thoughts on this subject?

Oh yes!

I believe that nutrition/supplements/diet, exercise and stress reduction all play a substantial role in preventing and combating both prostate cancer and the side effects of treatment. These tactics have been part of my own approach for my challenging case from the time I began learning about them in early 2000. There is a lot of solid evidence out there , although virtually none of it is absolutely conclusive. There is also a lot of bogus advice out there.

I first learned about nutrition from a handout in the office of the fifth urologist I consulted (three were second opinions), the doctor who has remained my urologist (though my oncologist manages my care). The handout was the work of Michael Milken, the financier and prostate cancer patient/advocate who founded the former CapCure Foundation, now known as the Prostate Cancer Foundation.

Soon I was learning a lot more from back issues of Dr. Charles Myers' Prostate Forum newsletters, which frequently covered nutritional topics related to prostate cancer. Over the years I've found him to be an excellent source, and I trust his recommendations. Several other doctors have also provided nutritional recommendations, and much of their work is good, in my opinion.

I personally want a certain quality of evidence before I commit to a nutritional tactic. For me, a pile of anecdotes, especially from someone trying to sell a product, doesn't cut it. I'm also not satisfied with impressive results in laboratory studies (culture dish experiments and the like) and animal studies. I belong to an organization that sells vitamins and other supplements, the Life Extension Foundation (LEF), that does an excellent job describing such research. However, for LEF, lab and animal studies are enough to get excited about a nutrient. I believe that without some human research, that is going off half-cocked and can be dangerous. I want some sound research of nutrients in humans, even better in men, before I commit. With all this in mind, here are some of the key nutritional tactics I believe in, keying on the major recommendations from Dr. Myers plus other items he favors but with less enthusiasm. I've found a preponderance of evidence in [url]www.pubmed.gov[/url] that supports each of these recommendations. Many of these are from his campaign "Tell One Friend How to Prevent Prostate Cancer".

No red meat - including pork: the danger is mainly from the aracidonic acid as well as the saturated fat.

Avoiding dairy fat and egg yolks.

Eating fish several times a week. Actually, my wife and I do that at dinner, but I have a few pieces of herring almost every day as part of lunch.

Consuming about 4,000 IU of fish oil per day.

"Avoid canola and flaxseed oil at all costs." The danger is from the alpha linolenic acid, which men (and older women) do not metabolize well, and which fuels prostate cancer. This is one of the few areas where what is good for women is not good for men. Men with cardiac issues will have to make a choice between supporting prostate cancer treatment versus cardiac treatment, as alpha linolenic acid appears to help some with cardiac problems. Ground flaxseed is a different story, we think. It may even be beneficial, as the oil it contains is far less concentrated than straight flaxseed oil, and the ground seed contains lignans, which may be beneficial for us. Olive oil is an excellent oil for us.

Eat a variety of fruits and vegetables. Broccoli comes in here, and it is better to cook it to release the nutrients we need. I have some at lunch every day, seasoned with cocktail sauce, which is a good source of lycopene.

Eat stewed or cooked tomatoes. They are excellent sources of lycopene, which research suggests helps us combat prostate cancer. Moreover, even heavy amounts of lycopene appear to be very safe, unless you are allergic to it or to tomatoes. Red and pink grapefruit and watermellon are also good sources. There is nothing wrong with raw tomatoes, but a lot of the lycopene remains encapsulated and passes right through us without being used.

Drink two to four cups of green tea a day. I currently try for ten bags worth of tea a day (five twelve ounce cups with two bags each). I always brew it with a few drops of lemon juice as that prevents rapid oxidation of the tea, which would decrease its potency.

200 mcg of selenium a day: This is the dose, taken daily for years, that appeared to cut the incidence of prostate cancer by about 61% in one very large, randomized, placebo controlled trial that was mainly aimed at skin cancer! Note that the dose is lower than the 400 mcg that you mentioned above. Recent reanalysis of data from the same large trial indicates there may be a very low risk of increased diabetes from taking selenium at a dose of 200 mcg for years. I reduced my dose from 400 mcg to 200 mcg when that study was published, and Dr. Myers has never recommended a higher dose. I get tested annually for diabetes as part of an annual physical, and I'm not close to being diabetic. A very large trial is now in progress to help determine whether selenium, vitamin E, or a combination of both are effective in reducing the incidence of prostate cancer. Unfortunately, we won't know the results for several more years. At one point Dr. Moyad opposed selenium consumption; I think he has since come around. Those of us living in areas where there is abundant selenium in the soil don't need supplementation; North and South Dakota and Nebraska are rich in selenium, and there may be other areas that are also rich. The Atlantic Coast and Pacific Northwest have low levels of selenium in the soil.

200 IU of vitamin E daily. This too appears beneficial in reducing prostate cancer risk. However, while a dose of 200 IU appears very safe, some cardio risk has been reported at doses around 400 IU daily and higher. Dr. Mark Moyad, another doctor who writes a lot about prostate cancer and nutrition, has focused on that fact to recommend against taking vitamin E. I think he is throwing out the baby with the bath water.

30 mg of lycopene a day. Dr. Myers feels that is useful as a backup to natural sources, which don't give many of us enough lycopene. I'm not fond of the added expense, and a recent study using a promising supplement, LyCoMato, was discouraging. It's not hard to get that much lycopene in the diet, and that's what I do. With a couple cups of V8 and some coctail sauce daily, I'm way ahead of the game.

At least 1000 IU of vitamin D a day. Actually, Dr. Myers and some other leaders in nutrition believe that you want to get your 25-hydroxy vitamin D blood test result to be in the 50 to 80 range, but aiming for less than 100. Some of us will need a hefty dose of vitamin D to do that, perhaps 3000 to more than 5,000 units per day or more. I was consuming about 3,000 to 4,000 IU per day last year, and with my other dietary sources, my score rose to about 140, which is not safe, alarming both me and my oncologist. I stopped all supplemental D over the winter and got the level down. The bottom line is that it is important to get the blood level tested. Dr. Myers considers vitamin D to be perhaps the most important nutrient for prostate cancer patients.

Other recommendations include:

Soy. A study led by Dr. Maha Hussain a few years ago found a benefit for prostate cancer patients from 200 mg per day. A lower dose did not help. Dr. Robert Leibowitz, a prominent medical oncologist specializing in prostate cancer, for many years has been adamantly opposed to soy for prostate cancer patients. I respect Dr. Leibowitz, but I'm convinced his evidence is weak. I get 200 mg of soy daily.

Resveratrol. A good source is red wine.

Dark chocolate.

It's getting late, so I'll break off here. This list covers most of the main territory.